Trapl et al reported the Gugging Swallowing Screen (GUSS) to evaluate a patient for dysphagia after an acute stroke. This can help to identify a patient who may be at risk for aspiration. The authors are from Landesklinikum Donauregion, Maria Gugging, Austria.
Patient selection: acute stroke
Preliminary Screen (Indirect Swallowing Test)
Parameter
Finding
Points
vigilance
no
0
yes
1
able to cough and clear the throat
no
0
yes
1
able to swallow saliva
no
0
yes
1
drooling
no
1
yes
0
voice change (hoarse, gurgly, coated, weak)
no
1
yes
0
Direct Swallowing Test: Done for semisolid, liquids and solid
Parameter
Finding
Points
deglution
not possible
0
delayed
1
successful
2
involuntary cough
yes
0
no
1
drooling
yes
0
no
1
voice change
yes
0
no
1
Testing does not progress to the next step if any of the parameters is 0.
subscore =
= SUM(points for each section)
total score =
= (points for preliminary screen) + (points for semisolids) + (points for liquids) + (points for solids)
Interpretation:
• minimum score: 0
• maximum score: 20
Score
Interpretation
Severity of Dysphagia
Aspiration Risk
20
all steps normal
none or slight
minimal
15 to 19
fails solids
slight
low
10 to 14
fails liquids
moderate dysphagia
some
0 to 9
fails semisolids and/or screen
severe dysphagia
high
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